Drug Safety: A Bitter Pill Initiatives
One day we hear about a newly introduced miracle drug;
Greater Washington steers away from medica-
the next thing we know it's being pulled from the market. Before your
tions once alarms are sounded, particularly when
counseling geriatric patients who are often frail
mouth can open to take a prescribed dose, fingers are already wiggling to assign
blame, from the drug companies to the Food and Drug Administration.
Following the recent publication of adverse
Amid the flurry of explanations, accusations, calls for hearings,
outcomes related to the diabetes drug Avandia,
denials, apologies, endless reports of drug trials, and disturbing
Dr. Patel decided to discontinue prescribing the
details of suffering, the bewildered consumer is left wondering
drug altogether even though many experts believe
what to do, whom to believe, and whose advice to follow, especially
its risks are only limited to patients with heart
when the stakes are as high as life and death. Sadly, there is no
"My reasoning," explains Dr. Patel, "is that
there are at least four older families of drugs in
addition to insulin injection that I can use to
The issue of drug safety and efficacy links directly to weighing
control diabetes without exposing my patients
the medical risks versus benefits of the drugs themselves and
to cardiovascular risk. For the same reason I
how the Food and Drug Administration (FDA) tests new drugs
stopped prescribing Vioxx even before the final
According to Janet Woodcock, M.D., director of the FDA's Center
time, on-site medical staff of the Hebrew Home
of Drug Evaluation and Research, "safe does not mean harmless.
Every drug comes with risks, and our tolerance for risk is higherfor drugs that treat serious and life-threatening illnesses."
Where to find information about drug safety
Speak candidly with your physician about the
At what point is a drug considered "safe?" An important 2002 study published in the
value and risks of any recommended prescription
Journal of the American Medical Association (JAMA), states that it may take years for
medication. To learn more about drug safety in
significant adverse drug reactions (ADRs) in widely marketed drugs to be reported.
general, start your research at these websites:
What's more, they point out, "only half of newly discovered serious ADRs are detected
• Food and Drug Administration, Center for Drug
and documented in the Physicians' Desk Reference within seven years after drug
http://fda.gov/cder/index.html
So, if you want a guarantee of a drug's safety, some scientists feel you might have to
• The Health Research Group, a division of Public
wait at least seven years from a drug's FDA approval date.
Citizen: www.citizen.org/hrg//drugs/index.cfm
The JAMA study recommends that "clinicians should avoid using new drugs when older,
• MedLine Plus, a service of the National Library
similarly efficacious agents are available." In addition, if patients insist on using a new
of Medicine and the National Institutes of
drug, they should be fully informed of its "limited experience and safety record." ■
Health: http://medlineplus.gov
• www.MedicineNet.com, owned and operated "We're really not doing a good enough job and demanding good data before a drug gets approved. They tend to be tested in healthy people against sugar pills for a brief period of time, and that's just not the information that patients and doctors need to have to judge that drug once it's out there."
- Dr. Jerry Avorn, M.D., Harvard Medical School
www.smithlifecommunities.org LifeTimes
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